Research Blog—PrEP Use for MSM and Transgender Woman Takes Center Stage at the International AIDS Conference 2016

Written by Dr. Matthew Thomann, Visiting Scholar at the IMPACT Program and an anthropologist and Postdoctoral Research Fellow at Columbia University Mailman School of Public Health and the International Center for AIDS Care and Treatment Programs.

Matthew Thomann, “The International Convention Centre in Durban, South Africa” July 18th, 2016

The 21st International AIDS Conference was held in Durban, South Africa last week, marking the first time the conference has been held on the African continent since 2000, when the demand for anti-retroviral treatment (ART) for those in the developing world reached its culmination in the same city [1]. The five-day long conference brought together more than 15,000 participants from 153 countries. The International AIDS Society describes the return to Durban this year as “a defining moment to establish a clear path toward guaranteeing that no one is left behind in the AIDS response” [2].

Central to this call is the potential of pre-exposure prophylaxis (PrEP), the use of anti-HIV medication to prevention HIV negative people from becoming infected to curb the epidemic, especially among key populations, including men who have sex with men (MSM) and transgender women. A 2014 New York Times Magazine profile piece featured PrEP users, many of whom were fearful of revealing that they were on treatment. Two years later, despite low overall uptake, much of that stigma has subsided, and PrEP use has increased by 332% in the United States [2]. Yet, its promise remains purely aspirational in places that are too poor to use patented versions.

Not unlike the 2000 conference in Durban, AIDS 2016 focused on ensuring that some of the most vulnerable and most affected by this epidemic are not left behind. Conference highlights focused on PrEP among MSM and transgender individuals included:

While many challenges remain to bring the “End to AIDS” that many health researchers and activists envision, PrEP is perhaps the greatest biomedical tool AIDS researchers and activists have in their toolkit. Yet its optimization will require more than strong science. In the Global Village, an organized community space open to the public and hosted by the conference, African HIV activists reminded conference attendees that the promise of PrEP will not be realized without them. Kenyan sex workers led a session and a Q&A session entitled “It Takes One to Know One: Sex Workers Pave the Way for PrEP in Kenya,” in which they advocated for the inclusion of community members in the implementation of prevention services, sharing their own successes lobbying for successful and sensitive PrEP implementation in their country. Their message was clear – strong science is only half of the battle. Community-engagement is key to ensuring the sustainability of any public health initiative, and PrEP is no exception.